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Updating The System

Doctors, led by a Tufts Medical School professor, have developed a new system to guide the liver transplant process, making the system more fair. Washington D.C.

Medford/Somerville, Mass. [11.19.01] Since demand outnumbers supply, many people in need of liver transplants get stuck playing a waiting game, often at the expense of their health. But a new system, just approved by a network of doctors led by Tufts' Dr. Richard Freeman, is designed to revamp the process and help patients who need it most.

"It's a much more objective way to rank patients," Freeman, a liver surgeon and professor at Tufts' School of Medicine, said in a Miami Herald article.

At the start of 2001, close to 20,000 patients were awaiting liver transplants.

The new system changes the emphasis from waiting times to medical necessity. Right now, the longer a patient has waited for a liver, the more likely he or she is to get a transplant.

"But many transplant experts believe waiting time is a poor way to measure how sick a patient is," reported the Associated Press. "For instance, some doctors encourage patients to get on the list before they really need a transplant so they can accumulate waiting time and be closer to the top when they need it."

The new system -- which Freeman and his colleagues approved 33-0 in a meeting of the United Network for Organ Sharing - uses more sophisticated medical criteria for managing transplants.

"The new system gives each patient a score based on three lab tests and is expected to predict better which patients will dies without transplants," reported the international news service.

The improvements will benefit patients, the Tufts doctor said.

"This is science now," Freeman told the Associated Press. "We're looking at this in scientific ways rather than emotional ways, which is really good for patients."